lar arrangement, possibly for enrichment purposes or
educational development.
The Census also found that the use of day care
was related to certain family characteristics, including
marital status, ethnicity, parental education, and
child age. Children of never-married parents were
more likely to be in relative (55%) than nonrelative
care (40%); children with married parents were equal-
ly likely to be in either type (49% each). Concerning
ethnicity, there were no large differences in use of
relative or nonrelative care between European-
American or African-American parents (about 50% of
children in both groups were cared for in each type),
but children of Hispanic parents were more likely to
be in relative (43%) than nonrelative care (34%). For
parental education, children of parents with at most
a high school diploma were more likely to be in rela-
tive (48%) than nonrelative care (38%); those with
parents with at least some college education were
more likely to be in nonrelative (59%) than relative
care (52%). Concerning child’s age, only 19 percent
of children under one year of age attended an orga-
nized facility, while 50 percent of children ages three
or four years attended organized facilities.
Family income was also related to type of care
used. Children of parents in poverty were more likely
to be in relative (41%) than nonrelative care (32%).
One factor that may contribute to this difference is
that relatives are often not paid while nonrelatives are
usually paid for their services. Children not in poverty
were equally likely to be cared for in both types (about
53% each). In addition, poor families spent on aver-
age 35 percent of their annual income on day care;
nonpoor spent only 7 percent on average. In 1997,
the National Institute of Child Health and Human
Development (NICHD) Study of Early Child Care
found that mother’s income, in particular, was associ-
ated with use of day care. Families that relied more
on the mother’s income placed their infants in day
care at an earlier age and used it for more hours per
week than families less dependant on the mother’s in-
come.
Effects of Day Care
The effect of day care on children’s development
is related to the quality of the care the children re-
ceive. The Cost, Quality, and Outcomes Study of
Child Care (CQO) investigated this issue and identi-
fied three levels of quality: low, mediocre, and high.
Table 1 provides characteristics of each level. Higher
quality was related to higher caregiver wages, higher
caregiver education and training, and lower adult to
child ratios.
This study examined the prevalence of each qual-
ity level. For preschool-aged children, only 24 per-
cent of the day-care center classrooms were of high
quality, 66 percent were mediocre quality, and 10
percent were low quality. For infants and toddlers,
only 8 percent of the classrooms were of high quality,
52 percent were mediocre quality, and a full 40 per-
cent were low quality. In a separate study of family day
cares, only 9 percent provided good quality care, and
a full 35 percent provided care that was potentially
harmful to children’s development.Health and Safety
The effects of day care on children’s health and
safety vary by the quality of the setting and the atten-
tion paid to these issues. Because their immune sys-
tems are not yet fully functional, infants and toddlers
are more susceptible to illnesses than older children.
Infectious diseases (mainly upper respiratory and gas-
trointestinal) are higher among children in family
day care and day-care centers than among children
cared for in their own homes. However, scrupulous
attention to hand washing and hygiene can cut the
rate of infectious disease transmission substantially.
Children in day-care centers may also be prone to in-
juries if the playground equipment is unsafe. This risk
can be reduced by paying attention to the height of
playground structures and the resilience of the sur-
face under the equipment. The American Association
of Public Health and the American Academy of Pedi-
atrics developed a document entitled ‘‘Caring for Our
Children’’ that provides comprehensive health and
safety guidelines for day-care facilities.Cognitive Development
The effects of day care on cognitive development
are also related to the quality of the setting. The CQO
study found that children in higher quality day care
demonstrated more advanced cognitive skills than
children in lower quality care. Specifically, their lan-
guage development was more advanced, and they
had better premath skills. In addition, compared to
children who received low quality care, children who
received high quality care in their preschool years
continued to show heightened cognitive skills into the
early school years.
The NICHD study researched this issue further
by examining both day care quality and family charac-
teristics. This study also found care quality to be relat-
ed to language development as well as school
readiness. However, family characteristics (such as
family income, mother’s vocabulary, and the home
environment) were more strongly associated with
children’s cognitive development than day-care expe-
rience. This study also compared children who were
and were not in day care and found that when familyDAY CARE 111